Do you need DRE's post surgery

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AEG
Regular Member


Date Joined Nov 2005
Total Posts : 154
   Posted 7/9/2007 10:01 AM (GMT -7)   
After surgery, do you still need to have a DRE performed during an exam?  If yes, what would the doctor check you for once the prostate is removed?
 
Thanks.
 
AEG
 

Mike A
Regular Member


Date Joined Feb 2007
Total Posts : 213
   Posted 7/9/2007 10:34 AM (GMT -7)   
AEG,
I'm scheduled for my second post-op exam tomorrow afternoon, and my Doctor told me that this time a DRE would be part of it. I'll ask him tomorrow what he is looking for, and if nobody has answered you by then, I'll report back.
Best,
Mike
June 2005 - Age 53 PSA 4.8 at regular physical
October 2005 - After several rounds of anti-biotics, PSA 5.2 at Urlogist
November 2005 - Biopsy negative
July 2006 - PSA 5.9 at regular Physical
October 2006 - After several more rounds of anti-biotics PSA 8.1
November 2006 - Second biopsy - Positive
December 2006 - Gleason (3+4=7), Tumor T1c, CT Scan and Bone Scan Negative
January 2, 2007 Robotic Prostatectomy, University of Rochester Medical Center - Tumor confined but larger than thought, only one nerve able to be spared. Margins clear.
February 2007 - Three to four pads a day, no erection with viagara.
March 2007 - Down to two pads a day, had first intercourse with Erecaid pump and bands, otherwise still flat tire.
April 2007 - First Post-Surgical PSA 0.02 and a great relief! Down to one pad a day. Still unable to achive erection without pump.
May, 2007 - Still one pad a day, even try a smaller pad on occasion. Slight improvement on the ED.
"If patience is a virtue, I feel like the most virtuous guy on the planet!"


wamba2000
Regular Member


Date Joined Jul 2007
Total Posts : 25
   Posted 7/9/2007 10:58 AM (GMT -7)   

I had the same question, and will be interested in the reasons.  My followup is schedule in August and Dr said he would do a DRE at that time.

Thanks for any feedback


Age: 56
Surgery: RP on 5/1/07
PSA: 4.1 (first test) 4.2 (second test)
Gleason: 6
 
Spread the word to men you know or meet: See your doctor. Have a PSA test early.


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 7/9/2007 12:29 PM (GMT -7)   
 
Today's thought is that a DRE is not necessary however, many Doc's still prefer the old tried and true exams. The DRE is mainly to check for any palpable signs of recurrence. More and more Physician's today believe the PSA is a such a reliable test (yes, there are a few rare exceptions), there is no need to palpate in the absence an elevation or other signs/symptoms.
 
Swim
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 7/9/2007 2:30 PM (GMT -7)   
A DRE post-op is not unusual. Typical recipients are those with climbing PSA'a post-op. Though unusual it is possible to detect a tumor recurrence if still in a positive margin area. So I've read. But I had 4 positive margins post op and a negative DRE pre-op for what that's worth.

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 7/9/2007 7:50 PM (GMT -7)   
    Last time I went in for a PSA the P.A. did a DRE on me.  Afterward he said that it was all clear and the he expected it to be!  I was thinking he might have just been doing it for the fun of it!!!!....;)
 
 
    KW
    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
    Gleason 7
    Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate
    RRP on Oct. 17, 2006 - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 3 weeks due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)
    Dr. said everything looks fine.  Continue to work Kegeal's. Leaking appears to have improved  after Cystoscope?!?!?!  Down to 3-4 pads per day!
    March 1st  Leaking has crept back up to 6 - 8 pads a day ??????? 
    March 8th Started Detrol LA to see if it helps with the leaking?
    March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking.  Worked for a couple of days then back to leaking.
    April 17th (Six Months Post Op) 2nd Collagen Injection to control excessive leaking.  Leaking started back next day at work!
    May 14th Second Opinion about my leaking and Options at OU Medical Center.  After reviewing my records the Dr. feels I will probably need some surgical intervention to stop my leaking.  But did agree to try Bio-Feedback and work hard on the Kegeal's first!
    May 30th Follow up with my Dr. and 3rd Post Op PSA 0.00 agian!!!
    June 1st Start Bio-Feedback to try to control my leaking.
   


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 7/10/2007 3:33 AM (GMT -7)   
AEG,

My physician did DRE's at two exams post surgery to make certain I was doing my Kegel exercises properly.  The physician had me contract while he felt the area where the urethra passes through the pelvic floor muscles.  I still benefitted from six more visits to my bio-feedback therapist to learn more kegel exercises.
 
CCedar
~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*
2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Confined:)
***************
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?


dawgfan
Regular Member


Date Joined Aug 2006
Total Posts : 148
   Posted 7/10/2007 10:24 AM (GMT -7)   
Just had my annual physical, which included a DRE. When asked, the doc said it was also done to check the colon.
Diagnosed 8/24/06
Gleason 6
PSA 3.32
stage T1C
age 48
daVinci on 10/20/06
Husband, Father, Son, Brother, Friend
"Never miss a good chance to listen."
 


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 7/10/2007 11:01 AM (GMT -7)   
Yep,

Every woman over 40 knows the routine...DRE is part of an ann^ual gyn visit. Beats the alternative.

Be Well, Swim
 


StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 7/10/2007 12:41 PM (GMT -7)   
dawgfan said...
Just had my annual physical, which included a DRE. When asked, the doc said it was also done to check the colon.


Never heard of this, is the DRE to check for colon cancer independent of prostate issues, or is there a higher incidence of colon cancer in prostate cancer patients? I wondered before if having prostate cancer predisposed me to colorectal, testicular or bladder cancer, but my urologist said no.
____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-12 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on Cialis, L-arginine and pentoxyfylline, ordered to be celibate for 6 weeks.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .200 (2 for 6)
- Trimix batting average: .500 (1 for 2)

"Lost in the valley without my horses, no one can tell me what my remorse is..."


Mike A
Regular Member


Date Joined Feb 2007
Total Posts : 213
   Posted 7/11/2007 6:30 AM (GMT -7)   
Hi AEG,
I had my six month post-op yesterday. I asked about this, and according to the Doc it's to check for any signs of tumor, especially along the pelvic bone, where Prostate cancer likes to metastasize. She also said it's a matter of some debate in the medical community, and not every Doctor does it. BTW mine was normal!
Best,
Mike
June 2005 - Age 53 PSA 4.8 at regular physical
October 2005 - After several rounds of anti-biotics, PSA 5.2 at Urlogist
November 2005 - Biopsy negative
July 2006 - PSA 5.9 at regular Physical
October 2006 - After several more rounds of anti-biotics PSA 8.1
November 2006 - Second biopsy - Positive
December 2006 - Gleason (3+4=7), Tumor T1c, CT Scan and Bone Scan Negative
January 2, 2007 Robotic Prostatectomy, University of Rochester Medical Center - Tumor confined but larger than thought, only one nerve able to be spared. Margins clear.
February 2007 - Three to four pads a day, no erection with viagara.
March 2007 - Down to two pads a day, had first intercourse with Erecaid pump and bands, otherwise still flat tire.
April 2007 - First Post-Surgical PSA 0.02 and a great relief! Down to one pad a day. Still unable to achive erection without pump.
May, 2007 - Still one pad a day, even try a smaller pad on occasion. Slight improvement on the ED.
July, 2007 - Six Month Post-op: PSA 0.04 still Non-Detectable. One small pad/day for a few drops only! No change in ED.
"If patience is a virtue, I feel like the most virtuous guy on the planet!"

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